The problematic Swedish Hiv-policy

In Arusha, Charles is waiting for the moment he will fall ill with Aids. He was branded an ”HIV-man”, sentenced to prison, forced to leave his children and deported for life. But can the law really protect us against our prejudices? And when did the death penalty become acceptable in Sweden?

Summer was approaching when Charles found himself in a police car for the first time. A day that would become his last day of freedom in Sweden. The uniformed women and men were wearing latex gloves and he heard them warn each other of ”the infected one” before they drove toward the prison.
In the police investigation that had previously been launched there were three women, two of which had been infected with HIV by Charles. He had known that he was HIV-postive for eight years.

Three months later, 8 September 1999, the sentence was declared: seven years in prison for aggravated assault and attempted aggravated assault. A penalty equal to that of manslaughter. After an additional three months the court of appeals stiffened the penalty to also include deportation from the country, barring his return. Although Charles` exwife testified to his close relationship with his two daughters, one four and the other nine years old, he was not considered to have a strong enough tie to Sweden.

Charles became the ”new HIV-man” in the newspaper headlines, a follower of the notorius and wanted Mehdi Tayeb. ”HIV-man” was the new media concept created for ”dark-skinned men without conscience who pick up light-skinned victims at the pub”.

Eight years later I am having Indian food with Charles in an openair cafe in the safari mecca Arusha in Tanzania. He is 44 years old today, an earnest man who speaks with small gestures. A man who came to Sweden as a 27-year old in love. A man whose life was radically changed thereafter. It is strange to speak like this, in another world now, about the hard events that took place

It was right here in Arusha that Charles met his wife 17 years ago, when she had the opportunity to work in the country. After a year she bccame pregnant and together they moved to her homeland, a sleepy little Swedish town. It was also in connection with the move they made the horrifying discovery that they were both HIV-positive.

”We set aside the discussion about which of us had infected the other,” says Charles. ”It was meaningless. It was all a question of whether or not our child would be infected.”

We speak with low voices, almost whispers, because Tanzania is no more tolerant than Sweden when it comes to HIV. And even if Charles now tries to meet other HIV-positive individuals through different networking groups the illness exists no more openly here than in Sweden.

”There is no right to infect someone else with HIV”. The statement was made by the former health minister, Morgan Johansson, at the Parliaments´s rostrum three years ago in a defence of the strict regulations and laws that surround HIV in this country. The statement summarises the general outlook on HIV. Few, apart from the HIV-organisations, protested.

Nowhere in the world are the penalties for transmitting HIV stiffer than in Sweden. And the consensus around the law and regulations seems complete: apart from the Left Party and to a certain degree the Green Party, the majority are for the most part in agreement that forced isolation, duty to inform and criminal prosection can be necessary tools to use when it comes to HIV: HIV is something that is always embodied as a person. A real danger, a crime against the Swedish natural way. HIV accumulates victims, but how do you penalise an illness? So HIV becomes a crime.

Charles is a ”typical” HIV case if you look through records of Swedish court proceedings. And even if the court proceedings are few – just a handful per year over the last six years – the headlines are nonetheless bigger. There is a distinctive pattern in the verdicts: when the indicted person is born in a land other than Sweden, they are normally penalised with deportation. In addition, prison terms range between two and six years, whereas in cases where someone is of Swedish origin the penalty never exceeds roghly two years.

The only exception that I find is a case where a man of Swedish origin committed rape against children – and recieved three years.

Is that mere chance? The cases are so few that most legal experts would be able to uphold it. Andreas Berglöf, a representative for the organisation HIV-Sweden has closely followed many of the cases that led to court proceedings and says that the ignorance surrounding the question is alarming. ”It is difficult to say anything in general about the judgements, but it is clear that we have suspicions that people from outside of Europe have received stiffer penalties simply because they were not born in Sweden. On the whole you can say that people have a one-sided fixation on medical journals and the fact that the HIV-positive person knew that he or she carried the illness, but never consideres conceiveable causes: the psychological parts that also come into play, the stigma surrounding the illness, how it can have the effect of keeping people silent.”

To discuss questions surrounding the objectivity in the courts of law and to question the consequences in jurisprudence is no simple task. Charles´lawyer, Peter Bergqvist avoids answering the question as to why it seems that the penalty of imprisonment is more severe for the non-Swedes that end up in court proceeedings. ”Looking at Charles´case you can say that there is a much stronger repudiation in the Court of Appeal than in the District Court, for example, and that is visible in the verdict that resulted in deportation. Just as you can sometimes experience an essentially emotional repudiation in a matter that involves violence against women, for example, you can likewise discuss it in this case. I do not consider it always wrong that a verdict resides on moral grounds, but to sum it up, it means that the person at hand, if they are unfortunate, can find themselves in situations where they recieve a more severe punishment if they are facing a judge that has ”stricter values.”

Charles´ life together with his wife and two children in the small Swedish town put strain on the marriage. He was home with the children and felt isolated. Eventually they split up and Charles moved to Stockholm. He worked cleaning restaurants and, no, it was not a particularly happy period. But during a visit to the children´s hometown he met another girl and fell in love. To explain that he carried the illness was self-evident. Their love was stronger than their fear. But this was going to be the last relationship ”that he dealt with,” as he puts it himself.

”Although I met someone, what was important was that everything was extremely tough during this period. The quarrel between my ex-wife and I continued long after the divorce and it carried over to the children. But the new relationship was important. I liked her. She came and visited more and more often and gradually we decided to move in together. But when she explained it to her family, they reacted strongly. They called everyday and said that she had to leave me. `Why are you risking your life for him?` they kept asking. One weekend she drove home to visit her family and never came back. I knew that something was wrong when she didnt´ come home that day. I worked at the pub until late and when I came home and was about to go in through the door two men emerged. They beat me to the ground and yelled `go home nigger` before disappearing. I got in the elevator and went up to my door. There they had painted `You live with an HIV-man` over the door and staircase. I called the police, but what could they do?”

When Charled received a threatening phone call a few days later with another demand to `go home`, he saw on the caller ID that it came from his girlfriend´s family home. And when he eventually spoke with her she pretended not to know what had happened. They never heard from each other after that.

”After that moment I started being unhappy and unsafe, especially when I came home late at night. I read in the newpapers about an African who was stabbed to death by two white men in a small town when he stepped off the bus. Their punishment was mild. It made me terrified. I was someone who had never been afraid before. I no longer felt safe at all.”

He began to have paranoid thoughts and feelings and found himself in the pub more and more frequently. First through the job and then through drinking in the evenings.

”I just tried to get through the days. I slept, worked and drank. The neighbours in my building also began to look at me strangely. One day in the laundry room there was a woman who said that I could only use one of the washing machines for my clothing. `Some people here know about you and your situation`, she said when I asked why. So I began to wash my clothes at home instead.”

Under Central Station in Stockholm is a pub where Charles usually went after work. Maybe it was not exactly his favourite place, but it was a place where other Tanzanians went, where he felt safe and could shut the rest of the world out for a while. This was just before everything caught up with him.

”A woman usually sat there. She was breaking up with her African boyfriend, so she also drank quite a bit. We went home together several times, always heavily intoxicated. In the beginning we protected ourselves when we had sex, but when she wondered why we were using condoms when she took birth control pills, I said nothing. I was scared to death to tell about myself. She asked things like why my laundry always hung on the balcony and never down in the laundry room. Another time she asked why so many neighbours looked at her strangely in the building. I still said nothing. It was like I became more and more frightened of being discovered as she came closer to the truth. When the police came one day, when it was all over, it was almost a relief.”

Nearly three months passed before the court proceedings began, because the police believed that even more women would come forward. But it stopped there. Altogether he met three women during this time that he had sexual relations with, according to Charles´ own words. Two of the women he slept with over the course of a few months´time, the third woman only a few times. She was the one who was not infected.

”During his time in prison I noticed that he realised hat he had done wrong. It was an insight that grew,” says Stefan Lindbäck, the doctor who treated Charles during his time in prison.

And Charles has had a lot of time to think about his responsibility since. But today he avoids talking about this with guilt. Maybe existential pondering do not exactly suit him. Maybe it is a too big of an issue. He has atoned for his crime according to the rules of the system; the community has returned order as prescribed. I do not know what he thinks; maybe there is not so much more to say? But he still wants to talk about it, in his way, explain the course of events. And there are his children, the children the Swedish medical services managed to save from being infected, who he wishes he could see more of, speak with more often to.

And then his `new`woman is there. The one he met during his time in prison, by mere chance, and who continues to stand at his side from Sweden, even after his deportation. The one who loves an `HIV-man`, and when she found out why Charles sat in prison also learnt to try to understand.
”HIV is not a characteristic of Charles`, it is an illness,” she says to me when we meet one day in Stockholm after my trip to Tanzania.
”But it sure is tough. I experienced dread, but later determined to learn as much as I can about both Charles´ case and the illness itself. Everyone I spoke with said you can certainly have an intimate, sexual relationship with an HIV-positive person, but I learnt at the same time that you cannot talk openly about the illness here.”

A person can become the subject of coercive measures according to the Swedish Infection- Prevention Law. Or an HIV-crime can become an offence in court proceedings. The Infection- Prevention Law classifies HIV amongst dangerous diseases where illnesses like hepatitis, syphilis and tuberculosis are also found. The law defines the regulations and orders that an HIV-infected person is obliged to follow. Infection-prevention doctors at local councils throughout the country makes sure that the patient follows the rules and can also, if the patient is seen engaging in ìnfectious`behaviour, decree incarceration, for example, as a form of forced isolation. Something that occurs very rarely nowadays. There is also the so-called duty to inform in the Infection-prevention Law, which means that the infected person is obliged to inform a partner that he or she carries the illness before they have sex or that he or she always uses a condom.

If a person files a police report asserting that he or she was put at risk for infection, it can lead to a criminal investigation and sometimes to trial in a court of law. The penal code has no specific classification that regulates HIV other than the classification that is used most often: aggravated assault or attempted aggravated assault. This is something criticised by certain legal experts.

”I think that the HIV-crime is clumsily lumped in under assault,” says the lawyer, Peter Bergqvist.

”I think there is a hell of a big difference between having sex with a person and exposing him or her to a risk for infection and hitting someone in the jaw. A big problem with lumping HIV-crimes under assault is the assessment of intent. If you hit someone you do not have to ponder whether the person had the intention of inflicting pain. But in the HIV-crime it is more difficult to settle the underlying factors.”

Peter Bergqvist tried to press Charles´ case in the EU Court to have the deportation reversed. But it was rejected by a divided jury. He also applied for a pardon for Charles with the Swedish government. ”The fact that Charles is going to become so sick that he will risk to die of aids over the course of few years is a consequence of the Swedish verdict with deportation. I think that respect for life should prevail here and it should at least make the justice department and government hestitate in executing a deportation ruling in a case such as this. But no, there was no hesitation whatsovever. He was sent to Tanzania. That is not showing sufficient respect for life”.

Charles´ deportation, like all the other deportations that follows a similar pattern, means, in other words, that he now lives entirely without medicines. Nor does he have access to a special ward for his illness, as there are nonone where he now lives.

”The fact that he doesn´t take any medicine means that HIV advances and breaks down the immune system,” says his HIV-doctor Stefan Lindbäck.

”In the end the immune system is so weak that the patient develops lifethreatening infections, so-called opportunistic infections that only affect people with extremely weak immune systems. During the time he took medicine we succeeded in suppressing the virus so that it was not measurable, but from the day he discontinued the medication the deterioration began.”

HIV involves sex because it is transmitted mostly through sex. And the community divides everyone into risk groups so that we can remedy, control, and manage an illness that at the same time only the Christian conservatives and other ideological affilations that push hard for sexual control have some hopes of being able to stop. In the HIV-reports we are fed with pictures of ”drug addicts, gays, whores and foreigners”. And somewhere in this a ´we ´is being created, a ´we´ that is healthy and absolutely detached from the illness, a `we`that can possibly only be affected as potential victims of a crime.
”We dare not talk about sex when we talk about HIV,” I consistently hear from the experts. At the same time that is what is done in court proceedings. It is impossible not to be struck by the overwhelming tragedy when reading through the trial records of the ”HIV-cases”. All the informality that characterises peoples´s meetings, sex, and relationships. A one-time twenty-minute sexual encounter, or part of a long, passionate relationship. All these situations that are now ground into records and that bring about consequences for the lives of everyone involved forever.

”They go to the bedroom and have sex with one another. The intercourse is vaginal. X states that they performed oral sex on each other without protection. They used a condom that they applied lotion to. Y had his penis in her mouth. He does not pull out. They perform anal intercourse.”

In public we ask the question: How could that person have sex so carelessly and ruthlessly, without informing the other person that he or she was sick? ”Had I known that he was sick I would have never had sex,” says one in the court records. ”I would never even have become friends with someone who was HIV-positive.”

There is a constant demand not to be confronted with the reality that we are living with since HIV was ”discovered” in in the beginning of the 1980s. Of course there are perpetrators and victims, the reality is undoubtedly sometimes brutal and ruthless. But can we really still construct our lives as though HIV does not exist around us, until the day a person learn he or she carries the illness oneself?

For Andreas Berglöf and his colleagues at HIV-Sweden it is not about defending a particular way of behaving. But they see the consequences in a country that convicts people with HIV as a warning to others. ”We do not work to defend the crime; rather, we are those who see the legal proceedings in themselves as having no effect on HIV prevention. It is not a matter of fewer people being infected in the country in spite of all the laws, regulations, and proceedings. Instead, the negative attention drawn by these cases complicates the ability to live normally for HIV-positive individuals”.

Could it be that the system itself contributes to fostering our attitydes in two diretions at the same time: one that silences, alienates, and contributes to distorting the psyche and the ability to accept and handle the responsibility of those infected, which is already traumatising; another that communicates the message that HIV is an illness that is personified by the type of unscrupulous `culturally-deviant`men like Charles, for example? HIV becomes an exception. It seems that we all avoid the responsibility for our own health and are made into victims.

Violence can be practiced through sex and there are a series of oppressive structures in the community that must be regulated. Perhaps Charles´ indifference was an expression of a type of such violence, but does it really suffice or help to set an example in order to prevent it from continuing to happen?

It has now been almost three years since Charles found himself on a plane taking him to Dar es Salaam where the deportation was carried out. Three guards accompanied him on the plane and as soon as they arrived at the passsport control they handed him over and walked away.

”I was left sitting in the airport until 5 o´clock in the morning. The Tanzanian authorities did not want to let me in. They thought that I was dangerous because I arrived accompanied by three guards: `you must have committed murder.` In the morning they managed to get hold of someone who could authorise the decision to let me into the country. Later I went to the best hotel in all of Dar es Salaam. A place where you hear the waves and feel a lovely breeze. It was a present from my girlfriend that she had arranged so that my first night in the coutry should go well.

It turned out that it was the same hotel that the three Swedish guards that deported me were staying at. So we sat there and talked awhile and everything felt so strange. I was angry about the way they left me at the airport. At the same time I wanted to show that I was nice. They talked about how they would travel to Serengeti and see the Masai people and go on safaris. Since I happen to come from the Masai people I was able to tell them a bit about it. It must have been really strange for them as well. They said that they had never done this, speaking like this to someone they had deported.”

We can all be angry at Charles and despair over the women who have been caused such suffering. But how should it be expressed? Suppose we perform an intellectual experiment: What would life be like if we all accepted the possibility that we are HIV-positive? Or risk becoming HIV-positive tomorrow or the next day. Ask yourself how many really feel affected by the insight that HIV has existed around us for more than 25 years and that presently there is no trace of a remedy on the way? The medicines in the western world are becoming more effective. New decelerating medicins are being introduced. But how do we live in practice? To judge by sexually transmitted disease statistics, few and fewer younger people are protecting themselves. HIV is considered to be an illness for `them`, not for `us`. Those who are not infected tend to not feel any responsibility for the existence of HIV and it is not just at the expense of HIV positive people: we all lose the power of protecting ourselves together.

I am driving together with Charles and we visit a hospital in Arusha. He has a friend who broke her leg and we sit for awhile with her in a room filled with hospital beds and people that all have an arm or leg held in an elevated position by plastic bags filled with stones. For a couple of days we talked about his life in Sweden, but now we are back in Charles´ everyday life, the life he lives now. I stick the money I have in my pocket in his friend´s hand for a back operation she needs, but cannot afford. It is 20,000 shillings, which my white guilt places in her hand, equivalent to 100 Swedish Kronor. When we leave, Charles points to a house next door, that is closed to visitors.
”That is where everyone with Aids lies just before they die. And that is where I am also going to end up later, ” he says.

”It is difficult not to think about that now, even if I try not to.”

Anna-Maria Sörberg

This article ”Hiv-man sentenced to death” was originally published in the swedish magazine ”Re:public Service” 10 may 2007 as part of my upcoming book project ”The Malaise” which discusses the Demon of the 21st century, the politics of fear and ”hiv as violence”. The article was translated into english 2007 and published in the book ”For Diversity. Against Discrimination” as one on the winning articles in the EU Journalist Award 2007.